After using the medit i500 scanner at an office as an employee, I purchased it from Cad-ray,com specifically because of their good reviews and their large, concise training library of videos. I've used CEREC as an instructor at a dental school and bo...read moreAfter using the medit i500 scanner at an office as an employee, I purchased it from Cad-ray,com specifically because of their good reviews and their large, concise training library of videos. I've used CEREC as an instructor at a dental school and bought a used Planscan, Planmill for my private office. Both were hard to learn and the fees and cost associated with training were a bitter pill to swallow after the costs to purchase. The ease of seating restoration was instant. The scanning learning curve is quick. I have easily added occlusal guard scanning, and implant scanning and will be trying a digital denture soon.
The purchase was easy, the product came quickly and the set-up videos guided me through very necessary adjustments to my Laptop I never knew I needed. Learning the new features with each FREE update is a treat. The DIY option was an extra bonus as the $2000 rebate came without having to ask for it. Cad-ray has delivered more than I expected with the purchase of the fantastic Mediti500 scanner.
I've included my cart set up. purchased from Amazon for $68. Its stable, has room for the necessities. I've taken it home and back to the office half a dozen times and it transports the scanner safely. It also keeps the cords from being run over. I haven't taken the included 2 day course but look forward too it after Social Distancing mandates are lifted.read less - 4/25/2020
Needed help with scanner updates and Frank is the man! Once he was done the scanner was operating in hyper-drive!!thanks frankoffice of Glenmont Dental - 2/15/2022
Suresh Patel
Kaila Larson is absolutely the best support person I have ever used. She knows her stuff and is a pleasure to work with. Medit is only as good as the support and SHE MAKES CadRay and Medit an amazing experience! - 1/05/2023
Dr. Terry Zervos, DDS,PA.
Today I had to order new tips and Laura was EXTREMELY helpful, Cad-Ray has all the products you need for digital dentistry and they do Education, if you buy Medit scanner from them they include 12 CE training course. Cant just buy a Lamborghini you h...read moreToday I had to order new tips and Laura was EXTREMELY helpful, Cad-Ray has all the products you need for digital dentistry and they do Education, if you buy Medit scanner from them they include 12 CE training course. Cant just buy a Lamborghini you have to learn how to drive it!read less - 7/02/2020
Sonrisas Dental
Support was our main concern, and we chose very carefully. Frank is 100% every step of the way - 1/25/2023
Travis Kendall
This scanner is amazing! It’s hard to believe that it is less then half the price of 3 shape with zero yearly charges. I highly recommend you give it a try! - 10/09/2019
CAD-Ray is amazing! Prompt replies, quick delivery, knowledgeable team! I had some cracks on my scanner that I read on their FB group may be a manufacturer's defect. My scanner was still covered under warranty. They overnighted a brand new one to me ...read moreCAD-Ray is amazing! Prompt replies, quick delivery, knowledgeable team! I had some cracks on my scanner that I read on their FB group may be a manufacturer's defect. My scanner was still covered under warranty. They overnighted a brand new one to me before I even knew they were going to replace it! That's how quick they are! Highly recommend them!!!read less - 12/23/2021
Maggie Sh
I’ve been using Medit 500 since spring of 2021 and really like it. The support system has been very good so far. I just called yesterday and spoke with Frank Deluca, he was very informative and helpful. - 12/07/2021
Melissa Poynter
Very pleased with Heather :) She has been able to solve any and all issues I may be having, and does so within the same day if not right away! - 6/16/2022
Reid Stone
I cannot say enough good things about Cad-Ray and the people involved with this organization. I have purchased equipment over the past few years from them and always been amazed at the non-pushy before the sale help and the after the sale support. ...read moreI cannot say enough good things about Cad-Ray and the people involved with this organization. I have purchased equipment over the past few years from them and always been amazed at the non-pushy before the sale help and the after the sale support. I have been deciding for the last 2 years to make a big purchase of a mill and sintering furnace and Jon has never made me feel like I was bothering him and never pushed me just to try to get a sale. It really is different from other sales experiences I've had with other companies/sales people.Jesse came out and installed and provided training for our new mill and sintering furnace. He went above and beyond what I was expecting to make sure myself and my team knew how everything works during the training. He has also been great with questions we have had since the installation. I just cannot say enough good things about my experience all around and will definitely be a Cad-Ray customer for many years to come. Thank you Cad-Ray!read less - 6/15/2022
Emerson Gower
Nothing but great things to say about Cad-Ray! Excellent customer support from Laura after the purchase of our Medit i500 and the cart from Damien. I’ve been very impressed with the Medit in restoring crown and bridge, as well as fixed hybrids, and...read moreNothing but great things to say about Cad-Ray! Excellent customer support from Laura after the purchase of our Medit i500 and the cart from Damien. I’ve been very impressed with the Medit in restoring crown and bridge, as well as fixed hybrids, and learning more of its capabilities each day. We have intentions to buy a second Medit shortly and will definitely be using Cad-ray again.read less - 12/13/2021
Jay Arnold DMD
Loving my Medit i700. My crowns have never fit better, and scanning is SOO easy. I started with cad-ray with the i500. The training and support have been second to none. I upgraded to the i700 shortly after it came out, and recently had a warranty is...read moreLoving my Medit i700. My crowns have never fit better, and scanning is SOO easy. I started with cad-ray with the i500. The training and support have been second to none. I upgraded to the i700 shortly after it came out, and recently had a warranty issue with the new scanner. immediately after calling them with my problem. A new scanner was overnighted to my office, I was very pleased, and had minimal down time.read less - 4/05/2022
AMISH DESAI
Awesome! Great support. If you are planning on getting a scanner, make sure you have Cad-Ray on your side ! - 4/20/2022
Chris Kleist
Cad-Ray is the absolute best if you're in the market for digital dental tools. I have purchased two Medit scanners through them. There will be hiccups with any complex piece of machinery, but every time I have needed Cad-Ray, they have been there. I ...read moreCad-Ray is the absolute best if you're in the market for digital dental tools. I have purchased two Medit scanners through them. There will be hiccups with any complex piece of machinery, but every time I have needed Cad-Ray, they have been there. I recently had a scanner go down. I called Cad-Ray tech support and they got me on the phone with Medit immediately. Within a day, a replacement scanner was sitting on my desk. It doesn't get much better than that.read less - 10/03/2024
Monika Reyes
For a few years I have been hesitating to get an intra oral scanner. I finally made the decision to get one and it turned out to be the best purchase I made in 2021!I love my Medit i700! - 11/23/2021
I ordered my Medit scanner from them in Feb 2020, so far no issues with support or the product. They are a great company with great support. Disclosure: they did promise me a scanner tip for this review, but in all honestly I was meaning to give it t...read moreI ordered my Medit scanner from them in Feb 2020, so far no issues with support or the product. They are a great company with great support. Disclosure: they did promise me a scanner tip for this review, but in all honestly I was meaning to give it to them anyway.... if you are looking to buy, this is a great way to go about it.read less - 7/19/2020
Franco Picofazzi
Great product at an affordable price, not to mention Andy's help at customer service. Highly recommended. - 6/23/2022
Medit i500 is an incredible scanner. I have experience with other types of scanners including IO and Desktop but this one is really impressive. It is blazing fast and takes beautiful scans. But more importantly is the company itself. Medit is an amaz...read moreMedit i500 is an incredible scanner. I have experience with other types of scanners including IO and Desktop but this one is really impressive. It is blazing fast and takes beautiful scans. But more importantly is the company itself. Medit is an amazing company and is constantly trying to improve. They are always on the cutting edge and releasing new improvements all the time. They are always LISTENING to the customers on how to improve the scanning experience and change accordingly. The customer service is second to none. I highly recommend this scanner but even more highly recommend considering buying the scanner as a result of the great company and PEOPLE that stand behind it.read less - 10/09/2019
Great scanner (medit i500) and mill (coritec one). They were great for an open system that allows me to do just about anything. - 6/16/2020
Jacob Rogers
I love this scanner. Seriously, how can you fit so much quality into the scanner, software and support and such a low price? Magic?!?! Probably. But, for real, we really like using this scanner and it produces great results. Best dental purchas...read moreI love this scanner. Seriously, how can you fit so much quality into the scanner, software and support and such a low price? Magic?!?! Probably. But, for real, we really like using this scanner and it produces great results. Best dental purchase I've ever made!read less - 10/09/2019
I got my 3Dshape scanner, great support , my training with Destany was excellent. Great team!! - 2/15/2024
Evan Bedell
Laura has always been so helpful with the medit when we needed assistance or resources. The training she provided the office was invaluable! She is quick to respond whenever we reach out. 13/10 - would recommend her to anyone looking to get a medit ...read moreLaura has always been so helpful with the medit when we needed assistance or resources. The training she provided the office was invaluable! She is quick to respond whenever we reach out. 13/10 - would recommend her to anyone looking to get a medit scanner.read less - 12/16/2021
Eric Bailey
Couldn't be happier with the support I've gotten from these guys. Trouble-shooting a problem real time so you can call a patient and get them right back in with a solution is extremely hard customer service to match. Thanks a ton and no question wher...read moreCouldn't be happier with the support I've gotten from these guys. Trouble-shooting a problem real time so you can call a patient and get them right back in with a solution is extremely hard customer service to match. Thanks a ton and no question where I'll be going for any more purchases!read less - 10/06/2021
Extremely good customer service. From start to finish buying my Medit was flawless and they were very helpful in offering me information. When I got my scanner I had questions and my phone calls were returned immediately. They knew my name and guided...read moreExtremely good customer service. From start to finish buying my Medit was flawless and they were very helpful in offering me information. When I got my scanner I had questions and my phone calls were returned immediately. They knew my name and guided me through what I would need. Very impressed. Would recommend!read less - 2/02/2020
The medit is one of the best scanners on the market with the best price. Cad ray's support and training is phenomenal and they are very quick to respond. We work with Laura. Highly recommend. - 12/16/2021
Gary Benson
Our orthodontic office is new to scanning and printing, but CAD-Ray, Laura, Medit, and SprintRay have made the whole transition a huge win. Our first scan and print was cleaner than any traditional impression/pour up we've ever produced. On our first...read moreOur orthodontic office is new to scanning and printing, but CAD-Ray, Laura, Medit, and SprintRay have made the whole transition a huge win. Our first scan and print was cleaner than any traditional impression/pour up we've ever produced. On our first full clinic day, we scanned 14 arches and managed to stay on schedule! We were waiting for this technology to be affordable, fast, accurate, and reliable, and we can now say we are there. Thanks for all your help and ongoing support.read less - 6/25/2021
Before working with cad-ray, I was hesitant to dive into digital dentistry due to the complexity of it. Working with Laura at cad-ray made all of my concerns go away. She was there to help me with my Exocad software installation, even outside of norm...read moreBefore working with cad-ray, I was hesitant to dive into digital dentistry due to the complexity of it. Working with Laura at cad-ray made all of my concerns go away. She was there to help me with my Exocad software installation, even outside of normal business hours - really hard to come by! I also purchased a Medit i500 and getting that setup and working in my clinic was seamless. I could not have asked for better support while navigating digital dentistry. My next purchase will be a 3D printer, and i know exactly where i will buy it from! Highly recommend these guys.read less - 11/20/2020
Brent Hale
Been using my i700 for a month now and it's been great. The tutorials that Cad-ray provides have been very helpful. This scanner with a fast computer turns out great results. - 11/01/2021
Best dental equipment company I have ever worked with! Great response and super helpful for any issues even years later. - 8/03/2023
Gregory Camfield
These guys are 1st in class service every time! - 7/08/2022
Samuel Schmidt
I purchased a SprintRay through them. I'm new to the 3D printer realm and they've been great with answering my questions and getting me set up. I've just really have been impressed with the quick responses, its much appreciated, thank you! - 4/20/2022
Miguel DeLeon
I seriously can't believe the amount of support I get from Cad-Ray. I bought a medit scanner 2 months ago through Laura and she was very quick to get it shipped to me. She helped me through the whole process and ensured that I was passed to the right...read moreI seriously can't believe the amount of support I get from Cad-Ray. I bought a medit scanner 2 months ago through Laura and she was very quick to get it shipped to me. She helped me through the whole process and ensured that I was passed to the right people to train me. They were always available whenever I called, even one time I ran into an emergency after hours and Kaila picked up and saved the night. Very cool how they can remote access to my computer and guide me through as if they were right next to me.I also recently bought an Ackuretta Sol printer with Laura's help and she got me paired up with Jessica for my printer training. Jessica is so awesome! She is very knowledgeable and guided me through a lot of troubleshooting and set me up for success.Thank you guys so much!! I will always refer my friends to you all.read less - 4/13/2022
Michael Pagano
I bought a Medit i500 from Cad-Ray. The service was fantastic. This group also does ongoing training to keep you up to date on how to use the technology.I had a minor issue with hardware and Cad-Ray resolved the issues no questions asked!They have a ...read moreI bought a Medit i500 from Cad-Ray. The service was fantastic. This group also does ongoing training to keep you up to date on how to use the technology.I had a minor issue with hardware and Cad-Ray resolved the issues no questions asked!They have a very active online forum that is supportive. I wouldn’t hesitate to purchase more equipment from them!read less - 10/13/2020
Alec Keon
I was on the fence on getting a scanner for years and finally pulled the trigger. CAD-Ray's support and knowledge has made this one of the best investments in my practice to date. When I spoke with Damien on the phone about my options he literally sa...read moreI was on the fence on getting a scanner for years and finally pulled the trigger. CAD-Ray's support and knowledge has made this one of the best investments in my practice to date. When I spoke with Damien on the phone about my options he literally saved me thousands after figuring out what my exact needs were. I went with the Medit i600, MSI laptop and 3D dental systems cart. The final product looks and feels as premium as it gets.read less - 2/21/2024
Shilpa Jobanputra
New user and absolutely love my Medit i500 scanner. Easy to use, fast, affordable and so quick for a first timer IOS user like myself. Customer service is fantastic, as are the sales people. It’s good to know you have strong knowledgeable people beh...read moreNew user and absolutely love my Medit i500 scanner. Easy to use, fast, affordable and so quick for a first timer IOS user like myself. Customer service is fantastic, as are the sales people. It’s good to know you have strong knowledgeable people behind the scenes ready to help at every turn. I would recommend this product highly. Happy in PAread less - 9/09/2020
Lisa Greenstein
Exceptional customer service - 7/26/2023
arthur lyford
I cannot say enough about the support I have received from the beginning. I chose CadRay ultimately because of the support reviews...I can attest first hand...they are all right on...though I have been practicing for more than 35 years, this old dog...read moreI cannot say enough about the support I have received from the beginning. I chose CadRay ultimately because of the support reviews...I can attest first hand...they are all right on...though I have been practicing for more than 35 years, this old dog has been taught a lot of new tricks from the support staff at Cad Ray...Truly impressed with every interaction so far! Thanksread less - 5/11/2023
Daniel Eley
I just bought the new Medit i700. I placed the order on Friday, it shipped on Monday, and it arrived on Tuesday. So far it has been a great experience. They also provide a lot of quality videos for learning to use the scanner. - 5/05/2021
Vivek Singh
I have had done business with these guys. I am impressed with their Amazing Customer service. John and Armen are great. I have and will order lots of stuff from them. Kudos to them!!!! - 6/19/2020
Northwest Orthodontics
Every staff member has been very helpful and kind every time we call. Thank you! - 7/24/2024
Yordanka Ivanova
I had been on the market for a scanner for a while and the i700 is my first intraoral scanner purchase. We are still new to the scanning world and its capabilities. Frank DeLuca was my main contact from the beginning and the person who did our traini...read moreI had been on the market for a scanner for a while and the i700 is my first intraoral scanner purchase. We are still new to the scanning world and its capabilities. Frank DeLuca was my main contact from the beginning and the person who did our training. The scanner is incredible and has surpassed our expectations even though we haven’t used it to its full potential yet. Frank has been amazing and always there to guide us every step of the way. Having such fabulous customer service and support from CAD-Ray was key for us when making this purchase decision. Thank you!read less - 6/23/2022
Geoff Seuk
Best service and support. Period. The product I purchased (Medit i500) is fantastic, but integrating it into my practice has been super smooth because of the support from Cad-Ray. They not only answer the phone with REAL people, but those people ACTU...read moreBest service and support. Period. The product I purchased (Medit i500) is fantastic, but integrating it into my practice has been super smooth because of the support from Cad-Ray. They not only answer the phone with REAL people, but those people ACTUALLY want to help you. Kind of a novel concept in this day and age. Definitely the best customer service I've experienced from an equipment dealer, and I've purchased equipment from just about all the big companies. Will definitely purchase from them in the future. I highly recommend them.read less - 8/07/2022
Cody Kriegel
Frank and the Cad Ray team have been nothing short of amazing. I continue to purchase digital equipment from Cad Ray because their support is unlike any in the dental industry. Frank has been instrumental in helping my team get the most out of our pr...read moreFrank and the Cad Ray team have been nothing short of amazing. I continue to purchase digital equipment from Cad Ray because their support is unlike any in the dental industry. Frank has been instrumental in helping my team get the most out of our products.read less - 1/25/2023
All Clear
Great experience with CAD-Ray, specifically Damien, with purchasing and customer service with servicing a scanner that needed replacing under warranty. All around excellent service and I will definitely come back for future technology we'll eventuall...read moreGreat experience with CAD-Ray, specifically Damien, with purchasing and customer service with servicing a scanner that needed replacing under warranty. All around excellent service and I will definitely come back for future technology we'll eventually be adding to our practice.read less - 10/23/2024
Kristian Dietz
My wife and I practice together and bought our first i500 in August of 2018. This was very early on before Armen had a vast number of technique and online support articles in his blog! Little was publicly known at the time about this new scanner bu...read moreMy wife and I practice together and bought our first i500 in August of 2018. This was very early on before Armen had a vast number of technique and online support articles in his blog! Little was publicly known at the time about this new scanner but I felt confident in my purchase for a few reasons: 1) Armen had validated the product and was standing behind it... I knew of Armen from DentalTown and had many years of public posts to evaluate his character; 2) Limited demos available at the time; 3) some clinical accuracy data out of Europe that required zooming in on a powerpoint presentation that was recorded second-hand via camera phone ha! SO needless to say, I put a lot of eggs in the "Armen is standing behind this product" basket. We have NOT been disappointed. From personalized service from both Frank and Armen, to our vast success and joy using the product and deciding in late 2018 to buy a second Medit i500, I have nothing but good things to say about the product and Cad-Ray. What a bunch of self-less individuals. Armen has offered to remote in and I even took him up on the offer once and he remoted in immediately to take a look at something. Good luck getting service like this from ANYONE else in the industry. Cheers to digital dentistry with the RIGHT partner. Kristian C. Dietz, DDSread less - 3/08/2020
There are may advanced ways that you can articulate the maxilla with the mandible if you happen to have models that are not accompanied by a bite registration or the arches were scanned intra-orally in separate folders as files
Generally, when you scan intra-oral and complete the case with both arches and the buccal bite, the models maintain their relationship to each other when exported to CAD software. But if you do not include the buccal bite scan, or if you scan the arches in separate files or cases, there is no way for a software to know how they are supposed to align with each other.
This simple video tutorial shows beginners how they can hand articulate the arches together with digital software. There are two steps you should take to make this an easier process to visualize, once you become comfortable with the moving models around as a system or as independent units. Crop the model at its base so that you can see through it and then turn on the feature “show distances” in exocad that will give you a color map and help you with alignment.
Obviously a bite alignment scan will come in hand, whether you use a desktop scan or an intraoral buccal bites scan
Once in a while, our users get themselves in a bind and you have to rely on manual alignment of jaws to each other. Sometimes, it feels like you are doing gymnastics to get the process to work. The sequence of how you import the models and how you set up the case is important in exocad.
Here we have 3 models; one of the upper, one for the lower, and one for the bite. Don’t ask how we ended up here:) The “direction of travel” is important to keep in mind, and as you can see in this video that is sped up, how the case was managed. if you bring in the upper and lower models in together, and then the bite, as soon as you align the bite to one jaw, you end up dislodging it when you tack it to the opposing jaw.
Reversing the sequence of import helps. We first bring in the upper jaw and the bite alignment and stitch those together. Then we bring the lower jaw into the equation and then merge that to the whole complex. Once that is done, the arches now know their relationships to each other and when you save each arch individually and import them into other programs, they will know exactly how to line up.
At the end of this video demonstration you can see how we re-import the two models in stl format just to verify that they do align properly
Don’t be mislead; it is much easier to scan the upper edentulous jaw than the lower, as you don’t have to deal with the tongue or saliva. With the Medit i500 we have a feature called the model display mode, where you can see how the meshwork is being formed by turning red areas to green. When scanning, you can image at the rate of “red colors turning green” so you can produce global accuracy across the arch without distortion or double images forming like you see with all intra oral scanners when they try and scan edentulous ridges on a flat plane
In this particular case, we demonstrate an emax restoration fabricated with the Z4 milling machine by VHF. In the first video, you can see how the case was set up initially within the software. You will notice how we image the preop, image the opposing and can even image the bite out of sequence, all while the patient is being anesthetized.
Once the preparation is captured, we place the margins and design a crown in exocad. The emax is milled, tried in, and them placed in the oven for crystallization. It is then delivered to the patient. Note how the decay at the contacts of the adjacent teeth was drilled out and restored, while the crown was milling / crystalizing. An immediate post op x-ray was taken to make sure there was no resin left behin
The Z4 Milling Machine can drill emax, zirconia and metal abutments. You can use a scanbody, identify the location of the fixture, design the abutment and mill our either ceramic or metal as the abutment.
Metal abutments in the posterior molar areas, tibases in canine and premolar regions, and angled abutments in incisor area is the general consensus for restoration of choice
One of the greatest advantages of the Z4 is that it can start milling while it is doing the calculation for milling. Furthermore, you can load multiple designs in preparation of continuous milling. In the picture attached, the CAM software is shown which operates in the background. Most users don’t usually see this interface.
Here you can see how there are 5 drills for the machine. The top tier, consisting of 3 drills, labeled G240, G100, and G060 are all labeled as R. The G120-T and G060-T are used only for a screw access holes
The following case demonstrates how a symptomatic cracked tooth was treated with an emax restoration that was fabricated / seated during the same appointment as it was prepared. The patient had a heavy gag reflex and the preparation and access were difficult. The medit i500 was utilized and the restoration was designed with CAD-Ray’s design software, powered by exocad, and then milled with the Z4 milling machine by VHF
In this pre-op of video, trans-illumination was utilized to highlight the lack of light propagation at the crack line. Moreover, the patient was percussion sensitive on the lingual cusps for over 5 days where he initially developed symptoms
The Medit i500 software was launched while the patient was anesthetized. The appropriate job definition was defined where we identified that a pre-op scan would be taken. We also identified the spacer parameters and the marked the opposing dentition. All of these items define the image catalog that will be launched when we capture the optical impression (there will be a preparation model, a pre-op model, the opposing, and minimally one bite registration)
While anesthetic was taking affect, salt on the tongue was used to suppress the gag reflex, and the opposing arch was imaged. Then the lower arch was scanned and the bite was captured. The software then was set to the mandibular arch where the tooth in question was cropped out of the equation.
A great benefit to this approach is that you can analyze if you have taken the bite registration correctly before you even image the preparation. Sine the medit i500 can capture color, you can can the patient bite down on articulating paper and pick up the color renderings while imaging. You can then compare the digital occlusal stamps to the ones left behind by articulating paper. This is a great way to gauge if you or the patient has introduced errors in the capturing the correct occlusal relationship between the upper arch and the lower arch
Since the patient was very sensitive while taking impressions of the tongue, the model of the preparation was built in multiple segments and steps. With the medit i500, the initial part of the preparation was imaged, certain areas were cropped out, then the tip of the camera was used to displace the tongue so the lingual margins could be captured. The image itself was capture in the local HD mode. The attached video demonstrates how areas were protected with the software so that we did not inadvertently introduce errors to areas that already had accurate data captured
Once the image was captured, it was processed and directly launched into CAD software. the pre-existing condition was replicated in the design of the crown and minor adjustments were made to its morphology while taking the opposing dentition into consideration
Once the restoration was designed it was automatically transmitted to the milling machine for fabrication. After it was milled, the restoration was checked for fit and contacts while in its blue stage and then crystalized in an oven. Once cooled it was seated with resin cement.
The Meditlink software has a Work File List that is maintained after you have finished your design. It hold the arches, the occlusion, the restoration stil file and the dentalCAD file that you can relaunch to either continue with a previous design or launch a whole new design
There are many ways to capture the upper and lower jaw digitally and mount them correctly in a protrusive and open bite for obstructive sleep apnea devices. In this videos, we feature how to digitize conventional impressions with the Medit i500 and mount them with a model creator so that that you order printed models and/or oral appliances.
Desktop scanners accomplish this much more readily, but it is a snap with intra-oral scanners. The key is to know how to pick up hidden and deep areas, which you can often correct by trimming away excess flash of impression material with a scalpel
One of the greatest challenges in oral appliances for obstructive sleep apnea therapy is to capture the bite in the protrusive and open position in such a fashion so that you reduce or eliminate any adjustments after delivery
One of the greatest benefits to capturing the arches digitally and relating to each other before production is that you eliminate most of these adjustments. Proper scans and proper prints of model for appliance manufacturing make delivery appointments just a few minutes long. We hardly ever open the exam kit anymore
A very important principle to keep in mind with intra-oral scanners is how that data is printed. There are too many reasons to list what can constitute a mis-print. One method to verify accuracy of your printed models is to scan them and take that digital model and merge them with your intra-oral scan model. You pick some common data points and manually align them.
Once that is performed, you can do “best fit matching” and the more green and blue you see in the color profile, the more accurately your meshwork or data points match each other. Once you do that you can take your slice tool and look at the contours of the data and see how well they relate to each other. In this case, we scanned the upper printed model and then merged it with the intra-oral scan used to fabricate the device. There was not a single adjustment made to the appliance for occlusion or for fit
The following case is a 4 unit splinted bridge where the upper central incisors where root canal treated. The laterals remained vital after trauma to the upper maxilla fracture a pre-existing bridge. In this single appointment procedure, the case was set up by imaging the pre-existing temporaries, the opposing and the bite.
After the preparation were made, the tissue was retracted and hemostasis was achieved. The preps were imaged in HD mode with the Medit i500 intra-oral scanner. The restorations were designed in exocad and the final prosthesis was milled with the Z4 VHF Milling Machine. A size 40 block was used to mill the splinted units of eMax.
The fixed bridge was seated with NX3 resin cement and the excess was removed. Cord, packed in the sulcus, allowed for easy identification of the margins in the design step and aided in cement clean up. The patient will return for post op photos once the tissue has healed. The following video depict the steps the milling machine goes through as it carves out the four unit bridge, starting with the 2.4 mm drill, then the 1 mm drill, and the 0.6 diameter drill. Milling time was under 40 minutes
Look at that contact area! A dentist’s and lab tech’s dream, but you still get some crowns that are way too tight and you adjust like crazy until it seats and if you were too aggressive, you likely blew right through the contact. Here is what is happening:
When you image what is happening is that you are imaging below the height of contours of the adjacent teeth / contacts. A designer just sees a big contact area with lots of colors and s/he is happy, not realizing that they actually made contact with material BELOW the height of contour of the adjacent teeth. This is a VERY common error. It will sound strange, but if you are an advanced user, consider NOT taking scans below the HOC and let the software drop a straight wall down to the gumline and your seat issues will disappear! You can also recognize this issue and communicate it to the lab so they can address it
This a case that was done in a single appointment, where the second molar was restored with a class 2 composite restoration and the first molar was replaced using the copy mode in exocad. An initial scan was taken copying capturing the outline form of the pre-existing restoration, the crown was then removed, the tissue was retracted and the preparation was modified
After the decay was removed the Medit i500 was used to capture the prep and the restoration was designed in our CAD software. The eMax restoration was milled and crystallized and then delivered with NX3 resin cement
This restoration was milled in the regular mode without using the 060 drill. This speeds up milling but does not provide for detailed anatomy, which you can accentuate with a handpiece. It is your decision to select fine mode, regular, or fast mode.
Since July, we have imaged and milled many restorations with at least 4 different milling machines, including lab fabricated restorations. The margins and fit have been impeccable even with my terrible preps :). I love seeing the post op bitewings and the adaptation of the restorations. One thing I love having control over is the spacer settings; both the amount of space and also the distance I want the gap to end from my margins.
The following case is a lower first molar with the distobuccal cusp fractured and recurrent decay underneath the pre-existing composite restoration, warranting full cuspal coverage. The case was managed with the CAD-Ray workflow, where the medit software is launched and all the imaging is done in that platform.
Directly from meditlink, exocad software is launched and the margins are placed. Once the restoration designed, it nested in the block and sent off to the milling machine. The total time from final design to end of mill was about 18 minutes, and the last 4 or so minutes, the milling machine refined the sprue size and location. One can easily stop the milling process and remove the sprue manually.
Once the restoration was assessed for fit and proper contours, it was chrystalized and then bonded in with Kerr NX3 material. A final post op bitewing was taken to assess if any excess cement was left behind.
This video is sped up at some points, but from the time the design was finished and it was sent to production, it tool less than 90 seconds for the milling machine to start milling. It took a total of 9 minutes and 20 seconds from the time the first water is sprayed to the time the water stops.
The Meditlink software allows you to log in as a clinician or a laboratory. There are quite a few benefits to logging in as a lab, one of them is to have control over the whole process from imaging to design to fabrication
Here, we demonstrate how the case is set up in the job definition. We have linked the exocad CS CADapp as the design software of choice. You have many other options including manually exporting the models.
Once you define the job, you can directly launch the Medit scanner and start imaging. Once you are finished with imaging, you can start marking margins and complete the design of the restoration in the CAD software.
Once designed completely, you have a number of ways to submit it tofabrication. One big advantage here is how you can start milling as soon the calculations start, with the VHF Z4 milling machine. As opposed to milling machines that must have the calculation completed before they start milling, which oftentimes puts the procedure outside the realm of single visit dentistry
Imaging highly reflective surfaces can be challenging. In this particular situation, every tooth had either a pfm or a gold crown restoration. The video playback feature of the medit software allows you to see exactly how these areas are managed and captured. in the live preview box in the lower right corner, you can see the purple silhouette which shows areas that cannot be seen. Just angle the camera and moving its focal length and angulation allows all the areas to be captured. Not retraction besides a mirror was used. No isolation, air, or suction was used. Both arches were captured for an obstructive sleep apnea device with the Medit i500
We had the pleasure of demonstrating the Medit i500 to a doctor today who happened to have a crown prep on the schedule. He had used an intra-oral scanner previously so it did not take much effort for him to use the device.
We first started by capturing the pre-existing condition. Then we captured the opposing arch. Both were captured in just a minute. We then captured the bite and put the camera aside. After the preparation was made, hemostasis was achieved and the doctor only had to impress the prepped tooth at this step, making the procedure very quick and easy.
A new feature in the meditlink software allows us to play back the video of how the arches were captured. You can get a very good sense of how things can work for you if you are looking to integrate into intra-oral into your practice. Contact us for a demo with an agent!
Scanning highly reflective surfaces can be a challenge with every intra-oral scanner. Here’s a pointer that can help: don’t start by trying to scan the metal or highly reflective surface. Get your purchase point on material that is easy to scan, like gum tissue or tooth structure. Once the model starts to form, you can then build on your desired material.
In this example, we are scanning a metal framework for a hybrid. Notice how the scanner does not recognize the metal at first, until it starts to image the thumb holding it. Once you start building the metal model and then remove the thumb and image over that area, the fingers are removed from the equation
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